Walking past a neighborhood fire station can be one of the most deeply reassuring experiences of city life—a reminder that there are people in our midst ready to pull on their helmets and stride into danger whenever and wherever something goes wrong.

But as a recent Globe story reported, city records show that major fires are becoming vanishingly rare. In 1975, there were 417 of them. Last year, there were 40. That’s a decline of more than 90 percent. A city that was once a tinderbox of wooden houses has become—thanks to better building codes, automatic sprinkler systems, and more careful behavior—a much less vulnerable place.

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As this has happened, however, the number of professional firefighters in Boston has dropped only slightly, from around 1,600 in the 1980s to just over 1,400 today. The cost of running the department, meanwhile, has increased by almost $43 million over the past decade, and currently stands at $185 million, or around 7.5 percent of the city’s total budget.

The trend in Boston is part of a striking nationwide phenomenon. The number of career firefighters per capita in the United States is essentially unchanged since 1986, but of the roughly 30 million calls America’s fire departments responded to in 2011, the last year for which statistics are available, only about 1.4 million were fire-related—down by more than 50 percent since 1981, according to the National Fire Protection Association. And while the total number of calls being routed to fire departments is higher than it’s ever been, only 5 percent of them are fire related. Most had to do with medical emergencies like heart attacks and car accidents. As a popular economics blog put it, alongside a graph based on the statistics, “Firefighters don’t fight fires.”

Of course, that’s not literally true—they do, and when fires occur, firefighters are better at containing them than ever. The existence of a fire department is perhaps the most classic example of a publicly funded good. But with little popular awareness of the shift, dealing with medical crises, rather than fighting fires, has become the core mission of the nation’s fire departments. This change, and the frequency with which it causes fire departments to overlap with other emergency services that taxpayers also pay for, has begun to attract the attention of experts who say the country is overdue for a rethinking of what firefighters are for, and what Americans should be counting on them to do.

Fire still has almost a unique power to motivate public anxiety and generate attention. But as cities like Boston wrestle with the tradeoffs caused by tight municipal budgets and competing demands of education, infrastructure, and public safety, it’s surely worth asking whether a system built more than a century ago to help protect us from fire offers the best approach to the very different sorts of emergencies that modern cities face today.

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Fire used tO routinely devastate America’s towns and cities. It wiped out almost all of Detroit in 1805, a vast swath of Chicago in 1871, and much of Boston’s downtown in 1872. Boston, as it happens, was the site of the first volunteer firefighting force in the New World: A group of about 20 neighbors who pledged in 1718 to protect one another’s homes as part of a so-called Mutual Fire Society. More formal volunteer organizations started cropping up after 1736, when Benjamin Franklin founded the Union Fire Company in Philadelphia. Before long, many American cities were home to multiple volunteer fire crews, which competed to be first on the scene to collect bonuses from local governments and insurance companies. According to historians, these bonuses ultimately proved to be the undoing of the volunteer firefighter movement. By the mid-19th century, street brawling between rival companies became so common that cities started shutting them down and replacing them with professional, municipally operated fire departments.

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In the years since, those fire departments have grown into a mighty force in American society. Specialized academies train new recruits; a large, powerful union lobbies on their behalf; and an arsenal of high-tech equipment has been developed to support them, including fireboats, haz-mat suits, and trucks that pump out more than a thousand gallons of water per minute. Firefighters are synonymous in American culture with bravery and selflessness; they are the ones who run toward trouble when the rest of us run away. Since 9/11, especially, when more than 300 firefighters lost their lives, they have been honored in terms once reserved for military heroes.

Actual fires, meanwhile, have sharply decreased. Today, office buildings made of fire-resistant materials are equipped with sprinklers, people’s homes have sensitive smoke alarms, smoking rates have plummeted, and cigarettes are designed to go out after they’ve been discarded. The war on fire, to a great extent, has been won.

Globe File/2004

In the world of business, when demand drops, so does supply; and when a company faces less call for its products, it gets smaller. Fire departments have proved extremely resistant to this pressure to shrink: As fires have declined, they have held steady or grown. This discrepancy has caught the notice of public-sector watchdogs, who worry about taxpayer dollars, and academic economists, who are appalled by what they see as an inefficient mismatch between public resources and the scale of the problem.

Fred McChesney, a professor of law and economics at the University of Miami School of Law, noticed this imbalance more than a decade ago, when he was a professor at the Northwestern University Kellogg School of Management living on a busy street in Evanston, Ill. “We had our share of traffic accidents, and we had some oldsters on the block so we had ambulances that would come pretty often—inevitably followed by a hook and ladder,” McChesney said in an interview. “Many a time they would clip off people’s mirrors....You’d look at this and say, ‘Why in the world are these people here?’”

Shortly after the 9/11 attacks, at a time when being critical of municipal fire departments was particularly radioactive, McChesney went public with his frustration, writing what would become a widely circulated essay called “Smoke and Errors.” He argued that firefighters have capitalized on their sterling reputation to strong-arm politicians into protecting their jobs. “We’ve got a small army of firemen out there and no fires,” said McChesney. “Do we really want that, especially when the money could be used elsewhere?”

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But while McChesney imagines firefighters “sitting around playing cards and brushing the dalmatian,” the truth is more complicated. Over the past several decades, firefighters have become all-purpose emergency service providers who respond to a wide range of situations that have nothing to do with fire. They deliver oxygen masks to people who are experiencing shortness of breath, revive people in cardiac arrest using automatic defibrillators, and administer CPR. They extricate people from car wrecks, deal with spills involving hazardous materials, and serve as a reassuring presence at accidents and crime scenes until an ambulance arrives and takes victims to the hospital.

Whether or not this shift in purpose is a good thing has lately been the subject of intense debate in Toronto, where a third-party review of the fire department in 2012 led the city to stop dispatching firefighters to 40-some types of medical emergencies that they used to respond to alongside ambulances. While firefighters there argue that the move has jeopardized people’s safety, EMS workers contend that there are only a handful of situations when the firefighters’ presence actually helps victims.

What’s indisputable, though, is that dealing with chest pains and shortness of breath is not what the public is imagining when they think about the work of firefighters. As McChesney put it, “That is not what people think they’re paying for.”

Alex Tabarrok, an economist at George Mason University who discussed the fire statistics on the blog Marginal Revolution, explains it in terms of what’s called the “March of Dimes problem.” When polio was defeated, the March of Dimes, started under Franklin Delano Roosevelt to combat the disease, suddenly had no reason to exist. “They were actually successful, and it was something they never planned for,” said Tabarrok. “But instead of disbanding the organization, they set it onto a whole bunch of other tasks...and so it’s kind of lost its focus. It’s no longer easy to evaluate whether it’s doing a good job or not.”

This, in Tabarrok’s view, is what happened to the country’s fire departments: At a certain point, they became an organization in search of a mission. “So they ended up doing things they’re not necessarily the optimal people to do, like responding to medical emergencies.”

Firefighters are familiar with this critique, and have an answer. Ken Willette and John Hall of the National Fire Protection Association, which recommends safety standards for American fire departments, argue that the evolution makes perfect sense. In their eyes, fire departments are well suited to the work of delivering emergency care, in terms of both training and the location of stations, which are deliberately spaced out in ways that minimize travel time. “You are getting two major services provided by a single entity and a single labor pool,” said Willette.

It doesn’t matter what we call them, in other words—firefighters are now responsible for responding to a wide range of emergencies, and that’s the role they play in our society. Some cities, like New York and Washington, D.C., have already incorporated this thinking, wrapping EMS and fire into one department. But some have not. In Boston, for example, they exist as two separate entities, and are frequently summoned simultaneously to the same emergencies.

Firefighters are often able to get to an emergency scene a few minutes earlier than an ambulance—in part because of the number of fire stations, and in part because ambulances are busier, whereas there’s almost always a fire truck free and ready to roll. The result is that in many medical emergencies in Boston—about a third of them, according to Boston EMS—we get a team of firefighters dealing with the situation for a few minutes, and then handing it off to EMS once the ambulance arrives.

According to Boston Fire Department spokesman Steve MacDonald, when the goal is the quickest possible response, a system that buys you even a little extra time makes a difference. “The early minutes of a medical call are critical,” he said.

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Whatever we as a society want our fire departments to do, the fact remains they’re still organized like fire departments. If we were designing an emergency response system from scratch today, it’s hard to imagine we would choose to structure the whole operation around the increasingly rare task of putting out fires.

So what would an alternative system look like? For Tabarrok, the solution is to shrink fire departments and spend the savings to pay for more ambulances, which would reduce their response time. “We shouldn’t be sending giant trucks through the streets all the time,” said Tabarrok.

Natalie Simpson, a professor of operations management and strategy at University at Buffalo who specializes in the history of emergency response, suggests getting rid of the 24-hour shifts that firefighters have traditionally worked. “That model is ancient,” she said. “When you start integrating emergency medicine into [the job], you have many, many, many more separate incidents....you need to go more to 12-hour shifts or 8-hour shifts, because the person needs to be rested.”

Unlike other observers, Simpson doesn’t believe that sending firefighters to medical emergencies is a waste of resources—redundancy, she says, can save lives.

“Your so-called fire department—they respond to unexpected events. That’s actually what they do,” Simpson said. “Maybe it’s a structure fire. Maybe it’s a rollover in the middle of the freeway involving three cars....Maybe it’s a report of a funny smell in a neighborhood that turns out to be a leaking propane tank. You can’t know in advance what the needs of the emergency are—that’s why it’s called an emergency.”

Looking at America’s fire departments, Simpson doesn’t see guys with hoses who occasionally deal with sick people—she sees all-purpose urban response squads, and believes that’s how we should talk about them.

But realizing how much an institution’s mission has changed is very different from figuring out how a city ought to respond to that change, especially with a tangle of interests, reputations, and public sentiment in play.

“The reality,” Simpson said, “is that these discussions will always become political.”